Impairments of Visuospatial Attention in Children with Unilateral Spastic Cerebral Palsy

Abstract

Aim This observational study aimed at assessing the prevalence of visuospatial attention deficits in children with unilateral spastic cerebral palsy (USCP), taking into consideration the affected hemibody and the localization of the brain lesion. Method Seventy-five children with USCP were assessed with four visuospatial attention tests: star cancellation, Ogden figure copy, line bisection, and proprioceptive pointing. Results A majority (64%) of children with USCP presented a deficit in at least one test compared to the reference values. The alterations observed in children with left or right USCP were related to egocentric or allocentric neglect, respectively. Children with cortico/subcortical lesion presented more often visuospatial attention deficits than children with periventricular lesion. Visuospatial attention deficits were not associated with brain lesion locations. Interpretation Visuospatial attention deficits are prevalent in children with USCP and should be taken into account during their rehabilitation process. The present results shed new light on the interpretation of motor impairments in children with USCP as they may be influenced by the frequent presence of visuospatial deficits.

Assessment of bilateral motor skills and visuospatial attention in children with perinatal stroke using a robotic object hitting task

“…Deficits in visuospatial attention may be the reason children hit fewer targets despite having largely normal magnitudes of movement during the task and may be especially true for the less affected arm. The widespread deficits found are consistent with previous findings on the prevalence of visuospatial attention deficits in hemiparetic cerebral palsy [19]. Our study is unique in that it assessed visuospatial attention in the context of a motor task, whereas most studies use traditional pencil and paper assessments, such as line bisection or star cancellation.…”

“…Visuospatial attention refers to the cognitive function of attending to relevant environment stimuli while ignoring irrelevant stimuli, and consists of the processes of alerting, orienting, and executive control [18]. Deficits in visuospatial attention in children with HCP have been previously documented using primarily pencil and paper tests, with a recent study finding that over 60% of a sample of 75 children with HCP failed at least one test of visuospatial attention [19]. While visuospatial attention deficits are found in children with both right and left hemispheric damage, deficits may be more common and severe when the right hemisphere is affected [20,21].…”

“…While visuospatial attention deficits are found in children with both right and left hemispheric damage, deficits may be more common and severe when the right hemisphere is affected [20,21]. Right hemisphere damage is more commonly linked to left egocentric neglect (neglect of space to the left of body's midline) [19], whereas the deficits with left hemisphere lesions may be more bilateral [19][20][21] and exacerbated by more complex tasks [20]. In an attention task involving listening, both right and left hemisphere lesions had deficits in shifting attention between sides [22].…”

“…In an attention task involving listening, both right and left hemisphere lesions had deficits in shifting attention between sides [22]. The type of lesion may also impact visuospatial attention deficits, with deficits being more prevalent in children with cortical/subcortical lesions (arterial stroke) compared to periventricular (venous) lesions, possibly due to the regions damaged [19]. While visuospatial attention is a known prerequisite to movement, the interplay between deficits in attention and motor impairments in HCP is not well understood.…”

Effects of dual tasking on postural and gait performances in children with cerebral palsy and healthy children

“…Gait impairments include slower speed, reduced step length, wider step width (Galli et al, 2010). Additional impairments include deficits in sensory and cognitive functions such as visuospatial attention (Ickx et al, 2018). CP children exhibit greater dual-task interference during standing and walking while performing a secondary cognitive task (Reilly et al, 2008;Hung and Meredith, 2014;Schmit et al, 2016Schmit et al, , 2015.…”